The Living Roots Project: Building a community asset and research consortium in Ealing, West London to address health equity

Lead Research Organisation: Institute of Development Studies
Department Name: Research Department

Abstract

This grant will support the scoping and formation of a 'community asset and research partnership' to build a 'living roots bridge' that brings together and explores community and public health linkages within the North West London (NWL) Integrated Care System (ICS) to tackle health inequity. Ealing is a 'superdiverse' borough in West London with racially minoritised and migrant communities, longstanding histories of mobilising for racial justice, and rich cultural and community assets. These assets include local parks, allotments, youth centres, a vibrant music scene, art galleries, and food hubs, to name a few. Here, there are vast inequities in health between groups linked to intersecting social determinants of health, including ethnicity, wealth and income.

Focusing on Ealing and through a 'syndemics' framework and participatory action research, we will (1) create shared understandings of the main problems related to health (in)equity and potential areas for change, (2) map and scope community assets and facilitate collaboration, and (3) explore collaborative models with a view to establishing one (or more) community asset and research hubs with linkages to the NWL ICS.

A 'syndemics' approach enables us to view health problems as interconnected, specifically looking at the social context which drives multiple health problems in disadvantaged populations. This is more robust than 'single disease' approaches which often dominate public health thinking. We will use transdisciplinary, inclusive approaches which critically, seek to build trust amongst partners, and with the aim of facilitating long-term collaboration through a sustainable, engaged research consortium for systems change, health equity and wellbeing in Ealing.

We envision that this project will benefit the wider Ealing community through 1) focusing on an 'assets' or strengths-based approach, which includes a better understanding of wellbeing, and 2) bringing together diverse, and also under-represented, voices to take action on health equity in the borough.
 
Title ActOne Cinema showcase including works from the weekly arts sessions (see above) 
Description This event showcased the artwork created by young people, with the aim of communicating to Ealing Council staff about youth experience in the borough, for example with challenges related to social housing. 
Type Of Art Artistic/Creative Exhibition 
Year Produced 2023 
Impact Young people's views communicated to Ealing council staff 
 
Title Experiences of South Asian Women: Stories of Health, Community, and Joy 
Description Book documenting experiences of South Asian women in Ealing, based on 'chai and chat' insight sessions that Voices of Colour led with 200+ women across the borough on issues related to health equity. 
Type Of Art Creative Writing 
Year Produced 2024 
Impact This was just recently published. 
URL https://docs.google.com/document/d/1d95jalWAbp-JAfJ0cAAP-hFyLxIGwi9z/edit
 
Title Health and wellbeing in Ealing: Spoken word poetry by Ami Kourouma 
Description Spoken word poem created by Ami on the theme of youth experiences of health inequity. 
Type Of Art Performance (Music, Dance, Drama, etc) 
Year Produced 2023 
Impact This spoken word performance was shared in various spaces - an Ealing mini conference on education, at local schools, and in our blog (reported separately). It has helped to stimulate changes in the way Ealing residents and policymakers perceive and understand marginalized youth experience in the borough. 
URL https://www.ids.ac.uk/opinions/unlocking-youth-voices-on-health-and-wellbeing-experiences-from-londo...
 
Title Living Roots Illustrated Theory of Change 
Description Theory of Change graphic for Living Roots, based on work by the Monitoring, Evaluation, and Learning team. 
Type Of Art Artwork 
Year Produced 2023 
Impact This Theory of Change has been used in various conference presentations, policymaker and practitioner presentations, and has effectively communicated the work we did on the project. 
 
Title Living Roots artworks 
Description Yasmin Dosanjh, our Arts and Wellbeing Coordinator, has been holding weekly sessions (3x per week) with young people who have been using multimedia arts to explore issues of health equity and wellbeing. For example, they are putting together an installation that includes a two-wheeler with artwork and audio about young people's lived experience of housing. 
Type Of Art Artwork 
Year Produced 2023 
Impact These artworks were displayed in a policymaker-oriented event (reported separately). 
 
Title Mental health cookbook 
Description Mental health cookbook with recipes and tips based on consultations and experiences of South Asian women in Ealing. 
Type Of Art Creative Writing 
Year Produced 2023 
Impact This mental health cookbook has helped South Asian women in Ealing to better identify, address, and understand challenges related to their mental health and wellbeing. It has contributed to reducing some of the stigma surrounding talking about mental health issues. 
 
Title River of Life 
Description Artistically depicts the journey of a young family from pregnancy to age 5, encountering challenges and getting needed support and services. To be used as a tool for policy makers, service providers and community members to improve health and wellbeing for diverse Ealing families. 
Type Of Art Artwork 
Year Produced 2024 
Impact Plans made for future activities. 
URL https://opendocs.ids.ac.uk/opendocs/handle/20.500.12413/18234
 
Title Youth created podcast: Live from South Acton 
Description This podcast was created to share the results of the youth peer-led research, what they learnt from the process, and how others can engage with young people in research co-design. Podcast created by our youth co-researchers, mixed and edited by Colin Brent from Bollo Brook Youth Centre. Covered topics related to youth experience and health equity in Ealing. 
Type Of Art Performance (Music, Dance, Drama, etc) 
Year Produced 2023 
Impact This podcast so far has primarily had an impact on the youth who participated in the research and serves as a documented record of their experience. We have not yet disseminated it widely. 
 
Description Our approach included community arts events; an informal mapping of community assets and actors; community consultation sessions to understand barriers to accessing and to discuss ways to improve health and local government services; training and supporting community peer champions; and a reverse mentoring programme to share community experiences and perspectives with local government staff and elected officials. We also engaged with the Public Health team around the recently published Health and Wellbeing Strategy (2023-2028) and held a community-based workshop to explore ways to co-design the strategy's action planning process (years 2-5).

Workstreams and achievements
Trained 10 peer champions. The Young Foundation and Voices of Colour co-developed a curriculum for training 10 Living Roots peer researchers, all of whom were recruited via an open call for applications. These 10 individuals were recruited to represent diverse voices and communities in Ealing, and ranged from younger to older adults, with representation from different towns. They completed a training and then were supported through mentoring to complete short action research projects on a topic of their choice. For example, two researchers explored how barbershops can be important spaces to support men's mental health. Several peer researchers have gone on to work on other funded research projects in Ealing.
Defining health equity in the vernacular: The Living Roots team (especially IDS, Voices of Colour, and Bollo Brook Youth Centre) have conducted exploratory work around how to talk about the building blocks of health.
Youth social action research. Steve Curtis (Ealing) and Megan (IDS) supervised three youth social action researchers employed on this project (Cameron, Amal, and Zak). They engaged with various small projects and have conducted exploratory research around what the building blocks of health mean to young people of colour in Ealing. This has included workshops in schools, peer research and short interviews, surveys, and engagement and linkages to existing youth services workstreams. Based on this and our 'youth advisory board' at Bollo Brook, we held a 'Express Yourself' event on 31st May which included music and songs around the theme of health and wellbeing.
Youth arts and wellbeing sessions. Yasmin Dosanjh (Bollo Brook) ran a series of arts and wellbeing sessions in South Acton and Northolt. These sessions included time with young people to explore various questions such as 'what does health mean to you' or 'what supports or takes away from you being able to live a healthy and flourishing life?' One young man explored how his Ethiopian identity shapes his life in Ealing today. This culminated in an arts showcase at Actone Cinema in Ealing: https://www.ids.ac.uk/opinions/unlocking-youth-voices-on-health-and-wellbeing-experiences-from-london/
Chai and chat insight sessions. Voices of Colour led a series of 'chai and chat' insights gathering sessions with 200+ South Asian women in Ealing. The analysis is ongoing, but preliminary findings demonstrated that the issue of mental health and mental health stigma is huge, especially in the 'post-COVID' era. Women felt like they cannot speak about mental health or access adequate services as these issues are not well-recognised in the community. Based on this, they created a 'mental health cookbook' featuring stories and artwork.
Reverse mentoring scheme pilot. Janpal Basran (Southall Community Alliance) and Steve Curtis co-developed a 'reverse mentoring' scheme which engaged a diverse group of 10 community mentors (e.g., people with lived experience) who 'trained' 10 policymaker/practitioner mentees around their experiences with a particular issue - e.g., the impact of regeneration schemes in Ealing, living with disability in the borough. Our hope is that this will contribute to improved linkages between policy and community and can support improved relationships of trust if taken to scale.
Workshop and convening to co-design approaches for a participatory and place-based action planning process for Ealing Council's Health and Wellbeing Strategy. Through engagement with 18-20 community representatives, we:
1. Shared and shaped principles and expectations for the action planning process.
2. Identified collaborative joint actions for the implementation of the Strategy's year one action plan.
3. Helped to widen participation in strategy engagement and implementation.
Linkages to the Enabling Early Childhood Development in Ealing project. This is a separate, funded project (led by Vaishnavee Madden, Tabitha Hrynick, Mariah Cannon, and Janine Shaw), which received funding during the Living Roots project and there were linkages between the two in terms of learning. They ran focus groups with parents and carers of young children across Ealing to ask them about their experiences and views of raising young children in Ealing to inform better services, including policy emerging around 'Family Hubs' in Ealing. Through the engagement of 1 Living Roots peer researcher and support for Tabitha's time, we bridged insights from this project with overall Living Roots learning.

Involvement of people with lived experience. Our core Steering Committee started with 8 people and grew to roughly 19 individuals, including added people from Ealing's Community Engagement team, social prescribing, IDS MEL, our youth co-researchers, and Ealing public health staff working with community champions and the Health and Wellbeing strategy.
We had 10 peer researchers, recruited via an open process, all of whom had lived experience and a range of ages, ethnicities, and abilities. They conducted research with a wider number of community residents on various projects.
We had 3 youth co-researchers (ages 21-25), recruited from Bollo Brook Youth Centre, all of whom had lived experience and are from minoritised backgrounds, and we also worked with a wider youth advisory board that ranged from 5-7 people. They consulted with over 150+ young people through school-based workshops and engagements at youth centres.
Our arts-based youth research included 15 young people with lived experience at youth centres in South Acton and Northolt, mostly from minoritised backgrounds.
The chai and chat insight sessions consulted with 200+ South Asian women in Ealing recruited from community-based sites and organisations, and wider consultations.

KEY LEARNING. The most important thing we learned from the project is something that we already knew, but this project has truly demonstrated the value of centring lived experience in research and health equity work. Whilst there was a huge amount of buy-in for this, the project showcased how this can be done in creative ways. Further, community consultations should start at the outset, at the project planning phase. We heard time and time again about 'consultation fatigue' and not linking community voices to action. In our future phase of work, we will prioritise the 'action' component, rather than the consultation piece.
Exploitation Route NEXT STEPS AND SUSTAINABILITY. This project has led to longer-term relationships between different organisations and individuals (e.g., Council and VCSE) which is itself sustainable and has led to other collaborations. Beyond the funding that our partners received to do work around early childhood, the Living Roots project contributed to conceptualisation for an NIHR Health Determinants Research Collaborative grant, which Ealing Council just recently received funding for the next five years. IDS and other Living Roots partners are taking part in this project, which in part will build up the community researcher programme and focus on the 'action' component - how do we link the peer researchers' work to action. We have also applied for Phase 3 funding from the AHRC, which would scale up our work and would more rigorously seek to understand and evaluate 'community connector' roles, which include peer researchers and others working at the interface of local government and community.
Sectors Healthcare

 
Description Our main area of impact is around health equity in Ealing, and it is too soon to measure this, however we do feel that our project has contributed to progress in this area. The Living Roots project contributed to higher outcomes such as increased understanding within the Council/ICS of community needs, greater youth and community participation and influence, and improved networks and partnerships (see graphical TOC image). Through a process of learning and reflection supported by IDS, and via our co-design of the workshop for Health and Wellbeing Strategy action planning, we brought together existing civil society organisation experience on health equity to inform a way forward. Through the peer researcher programme and reverse mentoring, peer researchers reported an increased understanding of health inequities and better awareness of community services. Across the project, this increased knowledge of community priorities and increased knowledge of spaces where community dialogue is happening. Further, the community arts events and other activities ('chai and chat' sessions) created better relationships between peer researchers, community, young people, and the Council/ICS. One unexpected outcome was that the Steering Committee itself contributed to project impact - it brought together people from different sectors who are not usually able to speak to each other, and there was a vast amount of learning and experience sharing through those regular meetings. This time invested led to stronger partnerships between smaller VCSE organisations and the Council, and showcased the need for more flexible and evolving partnerships. We are currently producing a final report and will compile all materials for a project website, which should be ready in early 2024. Enablers: The funding was the biggest enabler of the project. Additionally, having a dedicated Steering Committee with people who already had buy-in for the Living Roots approach (e.g., focusing on health as a social problem, not just an individual/behavioural one) was absolutely critical. All project collaborators were deeply dedicated to improving community engagement in health, which enabled those with lived experience to be truly at the centre of the project. The new Health and Wellbeing Strategy, which was published in June 2023, very much reflected these key themes and core Living Roots values, so that was an additional enabler - the positive policy shifts at the council level. The council has been engaged in a push to put 'communities at the heart of everything' and the Living Roots project has very much contributed to this. Barriers: A major barrier is the challenges to sustaining community involvement in health equity, primarily through a peer researcher programme. Practically, peer researchers have had to move on to other jobs or positions, and some are no longer available for the more ad hoc kind of research projects that come up. This is a question of sustainability and how to employ full-time peer researchers in Ealing, who can work across sectors and projects in the future. An additional barrier was that the North West London ICS was very new, and partners were still trying to figure out how to engage with this new system. While Steering Committee members were also a part of the ICS, it became difficult to link the Living Roots work to the ICS, which itself was very new and emergent. We hope that this can continue to develop in the future.
First Year Of Impact 2023
Sector Healthcare
Impact Types Societal

Policy & public services

 
Description Chai and chat' community insights sessions 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Voices of Colour has held a series of community insights sessions to understand challenges to health equity facing South Asian women in Ealing.
Year(s) Of Engagement Activity 2022
 
Description Express Yourself': Open Mic Night hosted by Bollo Brook Youth Centre 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact This evening, hosted at Acton Gardens Community Centre (next to Bollo Brook), was planned by our youth co-researchers who have done work around youth mental health and wellbeing. A major challenge to mental health is the current gentrification that South Acton is undergoing, and young people from minoritised backgrounds are feeling 'squeezed out' of physical and social spaces. Music, art, film, and poetry have been major outlets for Bollo's young people. We held this evening to provide space for them to talk about these issues and support one another. We had about 45-50 participants, including some parents and youth workers.
Year(s) Of Engagement Activity 2023
 
Description Health and Wellbeing Strategy Workshop 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Third sector organisations
Results and Impact "This one-day workshop on 21st July will brught together VCSE partners, H&WB representatives, Living Roots peer researchers and Ealing community champions, and interested community members/advocates to provide input into the action planning process for Ealing's Health and Wellbeing Strategy. Our goal was to produce a shared proposal document for the two elements of the action planning process, based on these discussions, including a theory of change that is framed by the Strategy's three themes and its building blocks to health approach.
"
Year(s) Of Engagement Activity 2023
 
Description Peer researcher training materials 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact The Young Foundation and Voices of Colour designed training materials for the peer researcher training programme for three-full days of content on participatory research design and data collection.
Year(s) Of Engagement Activity 2022,2023
 
Description Population Health Inequalities Group 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact This presentation to the borough-based inequalities group introduced our project to a wider stakeholder/practitioner audience that addresses public health in Northwest London.
Year(s) Of Engagement Activity 2023
 
Description Reverse mentoring programme 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact This programme was designed to pair community members with lived experience of health inequity in Ealing with Ealing council members. We facilitated 8 pairs of mentors-mentees that met at least twice, for example to learn about life as a young person in South Acton or living with disabilities.
Year(s) Of Engagement Activity 2023
 
Description Youth social action researchers' school-based sessions 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Our two youth social action researchers have been holding a series of school-based sessions with students to understand challenges that they face around the 'building blocks of health'.
Year(s) Of Engagement Activity 2023